The broad, long-term objectives of this subproject are to reduce the pain and suffering in persons with chronic pain as a secondary condition to a disability and to further test and refine a biopsychosocial model of chronic pain as it applies to persons with disabilities. The proposed study has two specific aims: (1) to evaluate the effects of a cognitive restructuring intervention on pain in a sample of adults with disabilities in a randomized clinical trial; and (2) to study the mechanisms of the effects of cognitive restructuring by determining whether treatment-related changes in cognitions mediate the effects of cognitive restructuring on pain. These aims will be accomplished through a longitudinal study in which persons with chronic pain as a secondary condition to a disability (N 240) will be randomly assigned to one of two experimental conditions. In the first condition, a cognitive-restructuring intervention, subjects will be instructed in cognitive strategies designed to eliminate catastrophizing and other negative thinking about pain. The second condition will be an education control intervention in which subjects will receive education about chronic pain. Measures of pain intensity, psychological functioning, pain interference with activities, participation, and medical services utilization will be collected at several time points throughout the course of the study (pre-treatment, posttreatment, follow-up). Findings from this study will increase our understanding of the efficacy of cognitive restructuring interventions as well as the causal role of catastrophizing in adjustment to chronic pain. The study will provide an important empirical test of one hypothesis derived from a biopsychosocial model of chronic pain: that cognitions influence pain experience and adjustment to chronic pain. Ultimately, these findings may also lead to the development and refinement of treatment strategies that will reduce suffering and improve functioning in persons with chronic pain.